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Q: I am a 23 year old man who exercises regularly. I have heard about the occurrence of possible sudden cardiac death during exercise and was wondering if I am at a high risk for this.
A: The most important cause of sudden cardiac death in young athletes is a disease referred to as hypertrophic cardiomyopathy. In essence, in this disease the wall of the left ventricular chamber of the heart is thickened. Although, quite generally, thickening of the left ventricular wall may occur as a consequence of high blood pressure, disease of the valves of the heart, etc., the thickening of the left ventricular wall in this disease is genetically transmitted and there is no apparent reason for its occurrence. In about 55% of the patients with this disease, this disease has previously occurred in other individuals of the same family, while in about 45% of patients with this disease, the disease just spontaneously appears.
The most frequent cause of death of individuals with this disease is the presence of arrhythmias, i.e., abnormal rhythm disturbances of the heart, which can be malignant and lead to death. The probability of occurrence of these rhythm disturbances is highest when the individual has had a previous history of loss of consciousness, a family history of sudden cardiac death, evidence of rhythm disturbances on electrocardiographic 24 hour monitoring, or when malignant rhythm disturbances may be seen to occur on a heart study referred to as an electrophysiologic study.
Because of the possible presence of this (or other) heart abnormalities in any individual, it is always important, regardless of age, that one always consults once doctor before starting a vigorous exercise program, so that the appropriate tests are done to rule out this or any other conditions, thus minimizing the risk of sudden cardiac death during exercise.
Updated: 11/26/98
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